|Publication number||US7988291 B2|
|Application number||US 12/499,079|
|Publication date||Aug 2, 2011|
|Filing date||Jul 7, 2009|
|Priority date||Apr 10, 2003|
|Also published as||US7556378, US8313196, US8632185, US20100030225, US20100036386, US20100042210, US20130131687|
|Publication number||12499079, 499079, US 7988291 B2, US 7988291B2, US-B2-7988291, US7988291 B2, US7988291B2|
|Original Assignee||Wavetec Vision Systems, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (99), Non-Patent Citations (86), Referenced by (1), Classifications (9), Legal Events (1) |
|External Links: USPTO, USPTO Assignment, Espacenet|
Intraoperative estimation of intraocular lens power
US 7988291 B2
Apparatus for performing intraocular implant surgery, including surgical apparatus for performing intraocular implant surgery, an autorefraction device associated with the surgical apparatus, wherein the autorefraction device is configured to perform autorefraction on the aphakic eye to provide one or more aphakic refraction measurements, and a processor connected to the autorefraction device, wherein the processor is configured to process the aphakic refraction measurements and provide the user of the apparatus with information regarding the power of the intraocular lens.
1. Apparatus for performing intraocular implant surgery, comprising:
a surgical apparatus for performing intraocular implant surgery;
an autorefraction device associated with the surgical apparatus, wherein the autorefraction device is configured to perform autorefraction on the aphakic eye following extraction of the native lens, to provide one or more aphakic refraction measurements; and
a processor connected to the autorefraction device, wherein the processor is configured to process the aphakic refraction measurements and provide the user of the apparatus with information regarding the power of the intraocular lens, and wherein the processor uses a predictive model that provides a relationship between the autorefraction measurements and the power of the intraocular lens.
2. The apparatus of claim 1 further comprising a display for providing the user of the apparatus with the information regarding the power of the intraocular lens.
3. The apparatus of claim 1 wherein the autorefraction device is attached to or integrated with the surgical apparatus.
4. The apparatus of claim 3 wherein the surgical apparatus is a surgical microscope and the autorefraction device comprises an autorefraction device configured to be moved into place for making refraction measurements following extraction of the native lens using the surgical microscope.
5. The apparatus of claim 1 wherein the autorefraction device is a portable autorefraction device that is configured to be used with the surgical apparatus while the patient is in a surgical position following surgical extraction of the lens.
6. The apparatus of claim 1 wherein the autorefraction device comprises a retinoscope.
7. The apparatus of claim 1 wherein the autorefraction device comprises a wavefront-based autorefraction device.
8. The apparatus of claim 1 wherein the autorefraction device comprises an apparatus for measuring the aphakic dioptric state, the deficiency of the ocular system, or both the aphakic dioptric state and the deficiency of the ocular system.
9. The apparatus of claim 1 wherein the autorefraction device comprises or works in combination with an external lens, contact lens, intraocular lens, or other component with refractive or medium properties positioned along the optical axis along an autorefraction measurement trajectory.
10. The apparatus of claim 1 wherein the surgical apparatus comprises a surgical microscope that includes an ocular piece or display for centration and positioning and a control for XYZ movement, and wherein the autorefraction device is positioned and configured so that the control can adjust the position of the autorefraction device relative to the eye.
11. The apparatus of claim 1 wherein the power of the intraocular lens comprises one or both of a spherical power and a cylindrical power.
12. The apparatus of claim 1 wherein the surgical apparatus is a surgical microscope.
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a divisional application of and claims priority to U.S. application Ser. No. 10/820,635, filed on Apr. 8, 2004 now U.S. Pat. No. 7,556,378. This application also claims priority to U.S. Provisional Application Ser. No. 60/461,429, filed on Apr. 10, 2003. The disclosures of the prior applications are considered part of (and are incorporated by reference in) the disclosure of this application.
This invention relates to methods and apparatus for selecting the power of an intraocular lens to be implanted into an eye.
The history of intraocular lens implantation dates back to 1949 when an initial attempt to replace a diseased lens with an artificial one resulted in a poor outcome with an error of −24.0 diopter (D). Nevertheless, this set the stage for continuous advances in the field of ophthalmology, leading to the common practice of “standard-of-care” lens implantation we see today. The technology of cataract surgery has witnessed an impressive development through constant innovation of surgical technique and instrumentation, lens material and design, and just as importantly, ever improving methodology for calculating and predicting the power of the lens implant necessary to achieve desired postoperative refractive outcome. In the 1960s Fyodorov was the first scientist to publish a formula for predicting the power of the intraocular lenses (IOLs) based on geometrical optics incorporating two very important preoperative anatomical parameters of the ocular system. A-scan derived axial length of the eye and keratometry measurements of the cornea, Feodorov S N, Kolinko A L. Estimation of optical power of the intraocular lens. Vestn. Oftamol; 80(4):27-31 (1967). Colenbrander published the first formula written in English in 1973. Colenbrander, Calculation of the Power of an Iris-Clip Lens for Distance Vision, Br. J. Ophthal. 57:735-40 (1973). Many further improvements followed these pioneering efforts. Binkhorst described a derivative formula in the 1970s. Binkhorst R D., The optical design of intraocular lens implants. Ophthalmic Surg 1975;6(3):17-31. Binkhorst, Power of the Pre-Pupillary Pseudoshakos, B.J.O. 56:332-37, (1972)). Modifications of the Colenbrander formula were implemented by Dr. Hoffer with further improvement of accuracy across the different axial length ranges. Hoffer K J. Mathematics and computers in intraocular lens calculation. Am Intra-Ocular Implant Soc J 1975; 1(1):4-5). In 1980, Sanders, Retzlaff and Kraff derived a regression formula which has sustained many subsequent updates and modifications. Further refinements were achieved with the second generation formulas which had better precision over a wider range of anatomic parameters, but all used axial length and corneal curvature (keratometry) as the main predictive variable in their models. Sanders, J. Retzlaff & M. C. Kraff, Comparison of the SRK II Formula and the Other Second Generation Formulas, J. Cataract & Refractive Surg. 14(3):136-41 (1988). Olsen, T., Theoretical Approach to IOL Calculation Using Gaussian Optics, J. Cataract & Refractive Surg. 13:141-45 (1987). Holladay, T. C. Praeger, T. Y. Chandler & K. H. Musgrove, A Three-Party System for Refining Intraocular Lens Power Calculations, J. Cataract & Refractive Surg. 14:17-24 (1988). J. T. Thompson, A. E. Maumenee & C. C. Baker, A New Posterior Chamber Intraocular Lens Formula for Axial Myopes, Ophthal. 91:484-88 (1984). Various improvements in making preoperative anatomic-based estimates of IOL power have been described in the patent literature (e.g., U.S. Pat. Nos. 6,634,751, 5,968,095, and 5,282,852).
The shortcomings of current technology are multifold. Even in the ideal and most simplified clinical setting, about 10-20% of patients remain with at least 1.0 diopter refractive error after surgery. In about 3-5% of cases this residual can be as high as 2 diopters. Also, traditional IOL estimation techniques based on axial length and corneal curvature produce even greater inaccuracy when the cataract surgery is done after vision correcting refractive surgery (e.g., Lasik, Lasek, wavefront and other similar corrective procedures). In this setting, a larger residual error can result (e.g., more than about 80% of such cases have about 1-1.5 diopter error). Reliance on anatomic measurements is even more problematic for a patient whose eye shape is at the extreme end of the range of an anatomic parameter.
Autoretinoscopy has been traditionally used for determination of the optical state of the ocular system in an office visit. In this office setting, autoretinoscopy is used as an objective measurement to guide the subjective testing and estimation of the power for corrective eye glass prescription. In this setting, an autorefractor based on the principle of automated retinoscopy, is used with the eye in the phakic state (i.e., with the native lens in its native position). A number of widely available autoretinoscopes are employed with the patient in a sitting position in front of the apparatus.
In recent years, very significant advances have been made in IOL surgical techniques and instrumentation (e.g., microincision techniques for quick and controlled cataract surgery), but IOL power has continued to be estimated preoperatively using anatomic measurements.
The problems associated with current methods for IOL power estimation lie in the reliance on preoperative measurements, e.g., corneal curvature and axial length. These parameters can change significantly after the eye has been manipulated. For example, the curvature of the cornea and its optical properties change after incisions and intraocular procedures. Current models extrapolate the effective lens position of the implant through lens-associated constants, such as the A-constant, which are inherent to the specific lens design, but not to the particular anatomy of each eye, and therefore not individually customized to each surgical case. The current methods, because they only approximate the optical deficiency of the eye after lens extraction, lead to residual errors in lens power.
In a first aspect, the invention features a method for selecting the power of an intraocular lens, comprising extracting the native lens, performing autorefraction on the aphakic eye to provide one or more aphakic refraction measurements, and determining the power of the intraocular lens from the one or more aphakic refraction measurements.
Preferred implementations of this aspect of the invention may incorporate one or more of the following. The autorefraction may be performed with the patient in the same position in which the native lens was extracted. The position of the patient may be the supine position. The method may be used for patients that have previously undergone vision correcting refractive surgery. Determining the power of the intraocular lens may comprise using a predictive model that is an empirically derived relationship between the autorefraction measurements and the power of the intraocular lens. Determining the power of the intraocular lens may comprise using a predictive model that is a theoretically derived relationship between the autorefraction measurements and the power of the intraocular lens. The native lens may be extracted using a surgical microscope and the autorefraction may be performed using an autorefraction device configured to be moved into place for making autorefraction measurements following extraction of the native lens using the surgical microscope. The autorefraction may comprise making a plurality of autorefraction measurements and averaging the measurements. Determining the power of the intraocular lens may comprise determining the power from the one or more autorefractive measurements and from other parameters. The other parameters may include preoperative anatomic measurements of the eye. They may also include one or more of the following: intraocular pressure, intraoperative axial length, intraoperative keratometry, preoperative keratometry, preoperative axial length, intraoperative anterior chamber depth, or preoperative anterior chamber depth.
In a second aspect, the invention features apparatus for performing intraocular implant surgery, comprising surgical apparatus for performing intraocular implant surgery, an autorefraction device associated with the surgical apparatus, wherein the autorefraction device is configured to perform autorefraction on the aphakic eye to provide one or more aphakic refraction measurements, and a processor connected to the autorefraction device, wherein the processor is configured to process the aphakic refraction measurements and provide the user of the apparatus with information regarding the power of the intraocular lens.
Preferred implementations of this aspect of the invention may incorporate one or more of the following. The apparatus may further comprise a display for providing the user of the apparatus with the information regarding the power of the intraocular lens. The autorefraction device may be attached to or integrated with the surgical apparatus. The surgical apparatus may be a surgical microscope and the autorefraction device may comprise an autorefraction device configured to be moved into place for making refraction measurements following extraction of the native lens using the surgical microscope. The autorefraction device may be a portable autorefraction device that is used while a patient is in the supine position following surgical extraction of the lens. The autorefraction device may comprise a retinoscope. The autorefraction device may comprise a wavefront-based autorefraction device. The autorefraction device may comprise apparatus for measuring the aphakic dioptric state, the deficiency of the ocular system, or both the aphakic dioptric state and the deficiency of the ocular system. The autorefraction device may comprise or work in combination with an external lens, contact lens, intraocular lens, or other component with refractive or medium properties positioned along the optical axis along an autorefraction measurement trajectory. The surgical apparatus may comprise a surgical microscope that includes an ocular piece or display for centration and positioning and a toggle for XYZ movement, and wherein the autorefraction device may be positioned and configured so that movement of the toggle can adjust the position of the autorefraction device relative to the eye.
Among the many advantages of the invention (some of which may be achieved only in some of its various aspects and implementations) are the following: Greater precision is possible in estimating required IOL power, and thus there is less residual refractive error. It is possible to achieve reductions in the complexity and cost associated with IOL implantation surgery (e.g., it may be possible to eliminate the need for expensive equipment such as an A-scan biometry device and a keratometer, as well as the need for a separate pre-operative patient visit at which pre-operative eye measurements are made). The invention makes it possible to break away from the conventional preoperative anatomical approaches derived from Feodorov's original work in 1967. New refractive measurement technology can be used to predict the power of the intraocular lens. Anatomic parameters such as preoperative axial length and keratometry are no longer essential to the process of estimating the power of the intraocular lens (but these parameters, as well as others, may, in some implementations, be used in combination with the intraoperative autorefraction measurements). Relying on intraoperative measurement of the aphakic refractive state of the eye after lens extraction has the advantage that it measures the optical deficiency of the ocular system without the confounding interference of the native lens. Modern retinoscopy technology can be adapted to cataract surgery immediately after extraction of the cataract, when the eye is transiently aphakic; in this state, the cornea is the primary refractive medium and the optical system of the eye is in a unique state of non-interference by the lenticular optical component. When an autorefraction or other form of retinoscopy is done before a lens is implanted, the measurements are primed to correlate closely with the missing intraocular lens power. From these measurements the surgeon one can derive, correlate and calculate the parameters of the lens to be inserted. The method can be used solely for the purposes described or in combination with other ocular measurements and parameters obtained prior or during surgery to optimize accuracy and precision.
Other features and advantages of the invention will be found in the detailed description, drawings, and claims.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is flow chart of steps in one implementation of the invention.
FIG. 2 is a diagrammatic view of apparatus implementing the invention in pone possible manner.
There are a great many possible implementations of the invention, too many to describe herein. Some possible implementations that are presently preferred are described below. It cannot be emphasized too strongly, however, that these are descriptions of implementations of the invention, and not descriptions of the invention, which is not limited to the detailed implementations described in this section but is described in broader terms in the claims.
FIG. 1 shows the process followed in one implementation of the invention. Any surgical technique for lens extraction may be used, including such conventional techniques as phacoemulsification or extracapsular cataract extraction. After the lens is extracted from the eye and all particulate lens material is removed, the anterior chamber is maintained formed with intraocular fluid or viscoelastic. The eye is then centered and an autorefracting device is used to obtain a refractive reading of the aphakic eye (i.e., the eye with the lens removed). While any autorefractor can be used across a wide range of possible vertex distances, one possible implementation is to use an autorefractor with a vertex distance of 13.75 mm, and to take an average of multiple autorefraction measurements. Autorefraction provides a spherical and a cylindrical power measurement.
The power of the intraocular lens can be derived from the refraction measurements. One possible method for deriving the intraocular lens power is to use an empirically derived relationship, which could be called a predictive IOL model, that relates the refraction measurements to the IOL power. This can be done, for example, by first calculating the aphakic spherical equivalent of the refraction measurements from the standard formula:
Spherical Equiv=Measured Spherical Power+½ Measured Cylindrical Power,
wherein Spherical Equiv is the aphakic spherical equivalent, Measured Spherical Power is the average of the spherical power measurements made using autorefraction, and Measured Cylindrical Power is the average of the cylindrical power measurements made using autorefraction. Next, the following empirically derived relationship may be used to relate the aphakic spherical equivalent to the IOL power:
IOL Power=A+c+b*(Spherical Equiv),
wherein A is the lens specific constant (and depends on the type of intraocular lens being implanted), c is an empirically derived constant, and b is the empirically derived linear correlation coefficient.
The two empirically derived coefficients c, b may be derived using a statistical regression analysis of data relating IOL power to autorefraction measurement of the spherical equivalent. For example, the regression analysis may be performed on data collected from a large population of patients (e.g., one hundred patients). For each patient, the data comprise the IOL Power selected using conventional preoperative measurements and the spherical equivalent from an intraoperative autorefraction.
Other relationships between the refraction measurements and the IOL power may also be used, and the necessary constants and coefficients derived either empirically or theoretically. One alternative, of course, is to simply combine the two formulas as follows:
IOL Power=A+c+b*(Measured Spherical Power+½ Measured Cylindrical Power),
Varying the vertex distance of autorefraction or modifying the optical media along the optical path (e.g., by inserting a different material into the anterior chamber of the eye, or by placing a temporary lens in or near the eye) can alter the parametric variables of the relationship.
In some implementations, the above formulation can be improved with additional variables to achieve better precision. Parameters such as intraocular pressure, intraoperative axial length, intraoperative keratometry, preoperative keratometry, preoperative axial length, intra and preoperative anterior chamber depth can be used as supplementary correlates in the predictive model, in order to refine the IOL power. For example, the following relationship could be used:
IOL Power=A+c+b*(Spherical Equiv)+d*(Axial Length)+f*(Average Keratometry)+g*(Intraoperative Pressure)
In one implementation, both the surgery and the autorefraction are performed using standard available equipment. A standard surgical microscope is used for extraction of the native lens, and a standard portable autorefraction device (e.g., a Nikon Retinomax) is used for autorefraction. Both procedures may be performed while the patient remains in the same supine position. The refraction measurements are read from the autorefraction device, and the IOL power is calculated using a formula such as one of those given above.
FIG. 2 shows another possible implementation in which specially designed equipment is used. An autorefraction retinoscope unit 10 is attached to the exterior of an ophthalmic surgical microscope 12. The surgical microscope in this implementation has its own display for centration and visualization. A toggle control 13 (and/or a pedal control) is provided for XYZ centration of the microscope and the retinoscope unit. The microscope has the usual lens array 15. The autorefraction unit can be a conventional automated retinoscopic apparatus of the type conventionally used to measure the dioptric deficiency and optical state of the phakic eye. The retinoscopic apparatus would be configured to operate with the patient in the supine position, intraoperatively, and to be moved out of the way of the microscopic surgical device when not in use, but configured so that its position and orientation is adjustable using the toggle control 13. A display unit 14 is integrated with the autorefraction unit 10 and also attached to the surgical microscope 12. The display unit presents the results of the IOL power determination. A processing unit 16 is electrically connected to the autorefraction unit and the display. Cables 18 make the electrical connections between the autorefraction unit 10, display unit 14, and processing unit 16. The processing unit receives measurement data from the autorefraction unit, and uses a predictive model (e.g., one of those described by the above formulas) to calculate the IOL power for display on the display unit.
An alternative to the arrangement shown in FIG. 2 would be to have the autorefraction unit, display unit, and processing unit fully integrated into the ophthalmic surgical microscope. For example, the same display unit can serve both for centration and visualization during surgery and for controlling and displaying results from the autorefraction unit and processing unit during IOL power determination.
The equipment of FIG. 2 or alternative implementations may be used to perform the eye surgery, to make the intraoperative refraction measurement, and to calculate the IOL power for achieving the desired emmetropia or postoperative refraction.
Many other implementations of the invention other than those described above are within the invention, which is defined by the following claims. For example, as earlier noted, completely separate surgical and autorefraction equipment may be used (e.g., with the microscope moved away, and the autorefraction equipment moved into place), and the IOL measurement may be calculated from the refraction measurements without using a special processor or display unit. Autorefraction may also be used after the intraocular lens is implanted (pseudophakic eye), to confirm whether a satisfactory choice has been made for the IOL power. If the autorefraction shows a residual error, the surgeon could immediately remove the implanted lens, and substitute another. Various types of autorefraction may be used to make the intraoperative refraction measurement of the aphakic eye.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US4125320||Jul 20, 1976||Nov 14, 1978||Optische Werke G. Rodenstock||Retinometer|
|US4172662||Sep 6, 1977||Oct 30, 1979||Carl Zeiss Stiftung||Eyepiece for measurement of lengths and angles by a microscope|
|US4173398||Mar 9, 1978||Nov 6, 1979||Asahi Kogaku Kogyo Kabushiki Kaisha||Optical system for objective eye-examination|
|US4293198||Sep 21, 1978||Oct 6, 1981||Canon Kabushiki Kaisha||Eye refractometer|
|US4353625||May 23, 1980||Oct 12, 1982||Nippon Kogaku K.K.||Eye-refractometer device|
|US4372655||Sep 13, 1979||Feb 8, 1983||Canon Kabushiki Kaisha||Automatic eye-refractometer|
|US4376573||Mar 18, 1980||Mar 15, 1983||Canon Kabushiki Kaisha||Apparatus for measuring the refractive power of the eye|
|US4390255||May 6, 1982||Jun 28, 1983||Nippon Kogaku K.K.||Eye-refractometer device|
|US4421391||Sep 26, 1980||Dec 20, 1983||Canon Kabushiki Kaisha||Auto eye-refractometer|
|US4459027||Oct 22, 1981||Jul 10, 1984||The State Of Israel, Atomic Energy Commission||Method and equipment for mapping radiation deflection|
|US4541697||May 16, 1983||Sep 17, 1985||Randwal Instrument Co., Inc.||Ophthalmic testing devices|
|US4640596||Aug 9, 1982||Feb 3, 1987||Humphrey Instruments, Inc.||Objective refractor for the eye|
|US4650301||Jun 22, 1984||Mar 17, 1987||Humphrey Instruments, Inc.||For measuring low level light images|
|US4669835||Jun 22, 1984||Jun 2, 1987||Humphrey Instruments, Inc.||Objective refractor for the eye|
|US4692003||Nov 7, 1983||Sep 8, 1987||Adachi Iwao P||Real-time analysis keratometer|
|US4710193||Aug 18, 1986||Dec 1, 1987||David Volk||Accommodating intraocular lens and lens series and method of lens selection|
|US4721379||Jun 23, 1986||Jan 26, 1988||Lri L.P.||Apparatus for analysis and correction of abnormal refractive errors of the eye|
|US4730917||Aug 28, 1986||Mar 15, 1988||Helmut Krueger||Of the human eye|
|US4911711||Dec 5, 1986||Mar 27, 1990||Taunton Technologies, Inc.||Sculpture apparatus for correcting curvature of the cornea|
|US4964715||Feb 14, 1989||Oct 23, 1990||Richards William D||Comparative surgical keratometer|
|US4984883||Jul 21, 1989||Jan 15, 1991||Joseph Winocur||Translation insensitive keratometer using moire deflectometry|
|US4995716||Mar 9, 1989||Feb 26, 1991||Par Technology Corporation||Method and apparatus for obtaining the topography of an object|
|US5080477||Nov 8, 1990||Jan 14, 1992||Yoshi Adachi||Surface topographer|
|US5157427||Apr 16, 1990||Oct 20, 1992||Allergan Humphrey||Objective refractor|
|US5164750||Nov 8, 1990||Nov 17, 1992||Yoshi Adachi||Aspheric surface topographer|
|US5206672||Sep 5, 1990||Apr 27, 1993||Nestle S.A.||Surgical optometer|
|US5208619||Jul 18, 1991||May 4, 1993||Allergan Humphrey||Automatic refractor, lensmeter and keratometer utilizing Badal optics|
|US5223863||Jan 7, 1991||Jun 29, 1993||Propper Mfg. Co., Inc.||Binocular ophthalmoscope with tilting mirror|
|US5252999||Oct 22, 1991||Oct 12, 1993||Nidek Co., Ltd.||Laser apparatus including binocular indirect ophthalmoscope|
|US5258791||Jul 24, 1990||Nov 2, 1993||General Electric Company||Spatially resolved objective autorefractometer|
|US5270749||Nov 27, 1991||Dec 14, 1993||Canon Kabushiki Kaisha||Opthalmic apparatus for measuring the refractive power of a lens|
|US5282852||Sep 2, 1992||Feb 1, 1994||Alcon Surgical, Inc.||Method of calculating the required power of an intraocular lens|
|US5294971||Feb 2, 1991||Mar 15, 1994||Leica Heerbrugg Ag||Wave front sensor|
|US5307097||Nov 5, 1992||Apr 26, 1994||Kera-Metrics, Inc.||Corneal topography system including single-direction shearing of holograph grating in orthogonal directions|
|US5329322||May 26, 1992||Jul 12, 1994||Yancey Don R||Palm size autorefractor and fundus topographical mapping instrument|
|US5374193||May 21, 1990||Dec 20, 1994||Trachtman; Joseph N.||Methods and apparatus for use in alpha training, EMG training and dichotic learning|
|US5450143||Aug 11, 1992||Sep 12, 1995||Nestle S.A.||Surgical optometer|
|US5455645||Apr 11, 1994||Oct 3, 1995||Lacrimedics, Inc.||Refractometer for measuring spherical refractive errors|
|US5493109||Aug 18, 1994||Feb 20, 1996||Carl Zeiss, Inc.||Optical coherence tomography assisted ophthalmologic surgical microscope|
|US5576780||Jun 6, 1995||Nov 19, 1996||Cain Research Pty. Ltd.||In an interactive virtual reality imaging system|
|US5777719||Dec 23, 1996||Jul 7, 1998||University Of Rochester||Wavefront sensor for determining the wave aberration of the living eye|
|US5796463||Nov 27, 1996||Aug 18, 1998||The Regents Of The University Of California||Apparatus and method for improving the operation of an autorefractor|
|US5800533||May 9, 1997||Sep 1, 1998||Harry C. Eggleston||Adjustable intraocular lens implant with magnetic adjustment facilities|
|US5861937||May 26, 1998||Jan 19, 1999||Nidek Co., Ltd.||Ophthalmic apparatus|
|US5909268||Oct 27, 1997||Jun 1, 1999||Nidek Co., Ltd.||Alignment detecting apparatus|
|US5936706||Aug 20, 1998||Aug 10, 1999||Kabushiki Kaisha Topcon||Ophthalmic instrument|
|US5949521||May 4, 1998||Sep 7, 1999||University Of Rochester||Method and apparatus for improving vision and the resolution of retinal images|
|US5963300||Feb 17, 1998||Oct 5, 1999||Amt Technologies, Corp.||Ocular biometer|
|US5968095||May 3, 1996||Oct 19, 1999||Pharmacia & Upjohn Groningen Bv||Method of selecting an intraocular lens to be implanted into an eye|
|US5994687||Sep 17, 1997||Nov 30, 1999||Thomson-Csf||System for correction the shape of a wave-front of a laser beam|
|US6002484||Jun 18, 1999||Dec 14, 1999||Rozema; Jos J.||Phase contrast aberroscope|
|US6004313||Jun 26, 1998||Dec 21, 1999||Visx, Inc.||Patient fixation system and method for laser eye surgery|
|US6007204||Jun 3, 1998||Dec 28, 1999||Welch Allyn, Inc.||Compact ocular measuring system|
|US6042232||Jan 21, 1999||Mar 28, 2000||Leica Microsystems Inc.||Automatic optometer evaluation method using data over a wide range of focusing positions|
|US6043885||Jan 8, 1998||Mar 28, 2000||Essilor International||Fringe deflectometry apparatus and method|
|US6050687||Jun 11, 1999||Apr 18, 2000||20/10 Perfect Vision Optische Geraete Gmbh||Method and apparatus for measurement of the refractive properties of the human eye|
|US6086204||Sep 20, 1999||Jul 11, 2000||Magnante; Peter C.||Methods and devices to design and fabricate surfaces on contact lenses and on corneal tissue that correct the eye's optical aberrations|
|US6095651||Jul 2, 1999||Aug 1, 2000||University Of Rochester||Method and apparatus for improving vision and the resolution of retinal images|
|US6096077||Aug 20, 1997||Aug 1, 2000||Thinoptx, Inc.||Deformable intraocular corrective lens|
|US6155684||Jun 16, 1999||Dec 5, 2000||Perfect Vision Optische Geraete Gmbh||Method and apparatus for precompensating the refractive properties of the human eye with adaptive optical feedback control|
|US6199986||Oct 21, 1999||Mar 13, 2001||University Of Rochester||Rapid, automatic measurement of the eye's wave aberration|
|US6251101||Jun 26, 1998||Jun 26, 2001||Visx, Incorporated||Surgical laser system microscope with separated ocular and objective lenses|
|US6262328||Jun 11, 1999||Jul 17, 2001||Westinghouse Savannah River Company||Sealed container|
|US6264328||Oct 21, 1999||Jul 24, 2001||University Of Rochester||Wavefront sensor with off-axis illumination|
|US6270221||Sep 20, 2000||Aug 7, 2001||Alcon Universal Ltd.||Apparatus and method for measuring vision defects of a human eye|
|US6271915||Sep 18, 2000||Aug 7, 2001||Autonomous Technologies Corporation||Objective measurement and correction of optical systems using wavefront analysis|
|US6275718||Mar 23, 1999||Aug 14, 2001||Philip Lempert||Method and apparatus for imaging and analysis of ocular tissue|
|US6299311||Mar 24, 2000||Oct 9, 2001||University Of Rochester||Rapid, automatic measurement of the eye's wave aberration|
|US6299618||Feb 14, 2000||Oct 9, 2001||Takeshi Sugiura||Intraocular lens insertion device|
|US6338559||Apr 28, 2000||Jan 15, 2002||University Of Rochester||Apparatus and method for improving vision and retinal imaging|
|US6379005||Jul 28, 2000||Apr 30, 2002||University Of Rochester||Method and apparatus for improving vision and the resolution of retinal images|
|US6382793||May 20, 2000||May 7, 2002||Carl Zeiss, Inc.||Method and apparatus for measuring a wavefront|
|US6382794||Sep 27, 1999||May 7, 2002||Carl Zeiss, Inc.||Method and apparatus for mapping a corneal contour and thickness profile|
|US6382795||May 20, 2000||May 7, 2002||Carl Zeiss, Inc.||Method and apparatus for measuring refractive errors of an eye|
|US6394605||May 23, 2001||May 28, 2002||Alcon Universal Ltd.||Fogging method for a wavefront sensor|
|US6409345||Aug 8, 2000||Jun 25, 2002||Tracey Technologies, Llc||Method and device for synchronous mapping of the total refraction non-homogeneity of the eye and its refractive components|
|US6419671||Dec 23, 1999||Jul 16, 2002||Visx, Incorporated||Optical feedback system for vision correction|
|US6439720||Jan 25, 2001||Aug 27, 2002||Aoptics, Inc.||Method and apparatus for measuring optical aberrations of the human eye|
|US6460997||May 8, 2000||Oct 8, 2002||Alcon Universal Ltd.||Apparatus and method for objective measurements of optical systems using wavefront analysis|
|US6497483||Mar 6, 2002||Dec 24, 2002||Alcon, Inc.||Apparatus and method for objective measurement of optical systems using wavefront analysis|
|US6508812||May 9, 2000||Jan 21, 2003||Memphis Eye & Cataract Associates Ambulatory Surgery Center||Control system for high resolution high speed digital micromirror device for laser refractive eye surgery|
|US6550917||Oct 20, 2000||Apr 22, 2003||Wavefront Sciences, Inc.||Dynamic range extension techniques for a wavefront sensor including use in ophthalmic measurement|
|US6570143||Sep 23, 1999||May 27, 2003||Isis Innovation Limited||Wavefront sensing device|
|US6572230||Jun 5, 2001||Jun 3, 2003||Metrologic Instruments, Inc.||Ophthalmic instrument having an integral wavefront sensor and display device that displays a graphical representation of high order aberrations of the human eye measured by the wavefront sensor|
|US6575572||Sep 21, 2001||Jun 10, 2003||Carl Zeiss Ophthalmic Systems, Inc.||Method and apparatus for measuring optical aberrations of an eye|
|US6578963||Apr 19, 2001||Jun 17, 2003||Alcon Universal Ltd.||Wavefront sensor for objective measurement of an optical system and associated methods|
|US6585723||Sep 2, 1999||Jul 1, 2003||Nidek Co., Ltd.||Corneal surgery apparatus|
|US6588902||Sep 25, 2001||Jul 8, 2003||Nidek Co., Ltd.||Ophthalmic apparatus|
|US6598975||Jul 31, 2001||Jul 29, 2003||Alcon, Inc.||Apparatus and method for measuring vision defects of a human eye|
|US6601956||Nov 15, 1999||Aug 5, 2003||Benedikt Jean||Method and apparatus for the simultaneous determination of surface topometry and biometry of the eye|
|US6609793||May 23, 2001||Aug 26, 2003||Pharmacia Groningen Bv||Methods of obtaining ophthalmic lenses providing the eye with reduced aberrations|
|US6609794||Jun 5, 2001||Aug 26, 2003||Adaptive Optics Associates, Inc.||Method of treating the human eye with a wavefront sensor-based ophthalmic instrument|
|US6626535||Dec 29, 2000||Sep 30, 2003||Bausch & Lomb Incorporated||Lens-eye model and method for predicting in-vivo lens performance|
|US6626538||Jul 11, 2001||Sep 30, 2003||Peter N. Arrowsmith||Method for determining the power of an intraocular lens used for the treatment of myopia|
|US6634751||Sep 10, 2001||Oct 21, 2003||Bausch & Lomb Incorporated||Intraocular lens derivation system|
|US6637884||Dec 14, 2001||Oct 28, 2003||Bausch & Lomb Incorporated||Aberrometer calibration|
|US6658282||Dec 19, 2002||Dec 2, 2003||Bausch & Lomb Incorporated||Image registration system and method|
|US6679606||Jan 8, 2003||Jan 20, 2004||Alcon, Inc.||Method for determining accommodation|
|US6685319||Sep 20, 2001||Feb 3, 2004||Visx, Incorporated||Enhanced wavefront ablation system|
|1||"IOL Power Calculations Piggyback Lens," http://doctor-hill.com/iol-main/piggyback.html, accessed on Feb. 24, 2010.|
|2||Aramberri, "Intraocular lens power calculation after corneal refractive surgery: Double-K method," J Cataract Refract Surg 29:2063-2068 (Nov. 2003).|
|3||Argento et al., "Intraocular lens power calculation after refractive surgery," J Cataract Refract Surg 29:1346-1351 (Jul. 2003).|
|4||Binkhorst, "Power of the Pre-Pupillary Pseudoshakos," B.J.O. 56:332-37 (1972).|
|5||Binkhorst, "The optical design of intraocular lens implants," Ophthalmic Surg 6(3):17-31 (1975).|
|6||Chen et al., "Analysis of intraocular lens power calculation in post-radial keratotomy eyes," J Cataract Refract Surg 29:65-? (Jan. 2003).|
|7||Coa et al., "Intraocular lens calculations in patients with corneal scarring and irregular astigmatism," J Cataract Refract Surg 29:1352-1357 (Jul. 2003).|
|8||Colenbrander, "Calculation of the Power of an Iris-Clip Lens for Distance Vision," Br. J. Ophthal. 57:735-40 (1973).|
|9||Collection of abstracts and citations of publications.|
|10||Combined International Search Report and Written Opinion of the International Searching Authority for International Application No. PCT/US05/13550; issued by the ISA/US; dated Nov. 15, 2005.|
|11||Feiz et al., "Intraocular Lens Power Calculation After Laser In Situ Keratomileusis for Myopia and Hyperopia-A Standardized Approach," Cornea 20(8):792-797 (2001).|
|12||Feiz et al., "Intraocular Lens Power Calculation After Laser In Situ Keratomileusis for Myopia and Hyperopia—A Standardized Approach," Cornea 20(8):792-797 (2001).|
|13||Feordorov et al., "Estimation of optical power of the intraocular lens," Vestn. Oftamol 80(4):27-31 (1967).|
|14||Final Office Action issued on Apr. 10, 2008 in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|15||Final Office Action mailed Feb. 1, 2010 in U.S. Appl. No. 11/110,653, filed Apr. 20, 2005.|
|16||Final Office Action mailed Oct. 29, 2010 in U.S. Appl. No. 11/110,968, filed Apr. 20, 2005.|
|17||Gernet, "IOL calculation according to Gernet and the GOW 70 PC programme," Abstract from Ophthalmologe 98:873-876 (2001).|
|18||Gimbel et al., "Accuracy and predictability of intraocular lens power calculation after laser in situ keratomileusis," J Cataract Refract Surg 27:571-576 (Apr. 2001).|
|19||Gimbel et al., "Accuracy and predictability of intraocular lens power calculation after photorefractive keratectomy," J Cataract Refract Surg 26:1147-1151 (Aug. 2000).|
|20||Gupta, et al., "Design and use of an infrared Pupilometer for real-time pupil mapping in response to incremental illumination levels," 2000 Optical Society of America, Total 4 pages.|
|21||Guttman, "Aberrometer Aims to Improve Refractive, Cataract Outcomes-Investigational Device Allows Evaluation of Wide Range of Eyes", Opthamology Times, Oct. 15, 2008, accessed Feb. 23, 2010, URL http://www.modernmedicine.com/modernmedicine/Refractive+Surgery+Feature/Aberrometer-aims-to-improve-refractive-cataract-ou/Article-Standard/Article/detail/559856.|
|22||Guttman, "Aberrometer Aims to Improve Refractive, Cataract Outcomes—Investigational Device Allows Evaluation of Wide Range of Eyes", Opthamology Times, Oct. 15, 2008, accessed Feb. 23, 2010, URL http://www.modernmedicine.com/modernmedicine/Refractive+Surgery+Feature/Aberrometer-aims-to-improve-refractive-cataract-ou/Article—Standard/Article/detail/559856.|
|23||Hamilton et al., "Cataract surgery in patients with prior refractive surgery," Current Opinion in Ophthalmology 14:44-53 (2003).|
|24||Happe W. et al., "Intraoperative Skiaskopie zur Bestimmung des Brechwerts einer zu implantierenden Intraokularlinse" [Intraoperative retinoscopy for determining the refractive value of an implantable intraocular lens] Klin. Monatsbl. Augenheilkd. vol. 210, No. 4, 1997, pp. 207-212.|
|25||Harvey et al., "Reproducibility and accuracy of measurements with a hand held autorefractive in children," Journal of Ophthalmology 81:941-948 (1997).|
|26||Hoffer, "Calculating Corneal Power After Refractive Surgery," Cataract & Refractive Surgery Today 4(4):23-25 (Apr. 2004).|
|27||Hoffer, "Mathematics and computers in intraocular lens calculation," Am Intra-Ocular Implant Soc J 1(1):4-5 (1975).|
|28||Holladay et al., "A three-part system for refining intraocular lens power calculations," J Cataract Refract Surg 14:17-24 (Jan. 1988).|
|29||Holladay, Jack T., "Refractive Power Calculations for Intraocular Lenses in Phakic Eye," American Journal of Ophthalmology, Jul. 1993, pp. 63-66.|
|30||Holladay, JT et al., Refining Toric Soft Contact Lens Prescriptions. CLAO J. 1984, 10:326-31.|
|31||Holladay, JT, et al. "Calculating the Surgically Induced Refractive Change Following Ocular Surgery", J. Cataract Refract. Surg. 1992; 18:429-43.|
|32||Hunt et al., "Evaluation of the measurement of refractive error by the PowerRefractor: a remote, continuous and binocular measurement system of oculomotor function," Br J Opthalmol 87:1504-1508 (2003).|
|33||Ianchulev, "Method for Intraoperative Refractive IOL Calculation," Poster Presentation at Ophthalmology Conference (Apr. 2004).|
|34||Ianchulev, et al., "Intraoperative optical refractive biometry for intraocular lens power estimation without axial length and keratometry measurements," Journal of Cataract & Refractive Surgery, vol. 31, Issue 8, pp. 1530-1536, Abstract.|
|35||Isenberg et al., "Use of the HARK Autorefractor in Children," American Journal of Ophthalmology 131(4):438-441 (2001).|
|36||Iwami S. et al., "Prediction of Postoperative Refraction Using Intraoperative Retinoscopy" Journal of Japanese Ophthalmological Society, vol. 103, No. 7, 1999, pp. 551-555.|
|37||Kora et al., "Intraocular lens power calculation for lens exchange," J Cataract Refract Surg 27:543-548 (Apr. 2001).|
|38||Liang et al., "Comparison of Measurements of Refractive Errors Between the Hand-held Retinomax and On-table Autorefractors in Cyclopleged and Noncyclopleged Children," American Journal of Ophthalmology 136(6):1120-1128 (Dec. 2003).|
|39||Liang et al., "Comparison of the handheld Retinomax K-Plus 2 and on-table autokeratometers in children with and without cycloplegia," J Cataract Refract Surg 30:670-674 (Mar. 2004).|
|40||Liang, et al. "Aberrations and Retinal Image Quality of the Normal Human Eye", J. Optical Society of America, vol. 14, No. 11, Nov. 1997.|
|41||Ma, et al., "Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation," J Cataract Refract Surg, Technique, Oct. 2008, vol. 34, pp. 1631-1636.|
|42||Masket, et al., "Atlas of Cataract Surgery," Book cover in 1 page, Front Matter in 11 pages (Table of Contents in 3 pages), Chapter 19 pp. 147-158, Published by Martin Dunitz Ltd 1999, United Kingdom.|
|43||Moreno-Barriuso, et al., "Laser Ray Tracing Versus Hartmann-Shack Sensor for Measuring Optical Aberrations in the Human Eye", J. Optical Society of America, vol. 17, No. 6, Jun. 2000.|
|44||Nemeth et al., "Optical and ultrasound measurement of axial length and anterior chamber depth for intraocular lens power calculation," J Cataract Refract Surg 29:85-88 (Jan. 2003).|
|45||Non-Final Office Action issued on Jul. 11, 2007 in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|46||Notice of Allowance issued on May 26, 2009 in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|47||Notice of Allowance issued Sep. 28, 2010 in U.S. Appl. No. 11/110,653, filed Apr. 20, 2005.|
|48||Office Action dated Nov. 2, 2010 in Japanese Application No. 2007-509613 (with English Translation).|
|49||Office Action issued in Australian Patent Application No. 2005234778 dated Apr. 6, 2010 in 2 pages.|
|50||Office Action mailed Dec. 25, 2009 in Chinese Patent Application 200580011803.6 filed Apr. 20, 2005.|
|51||Office Action mailed Feb. 28, 2011 in U.S. Appl. No. 12/581,061, filed Oct. 16, 2009.|
|52||Office Action mailed Jan. 15, 2010, issued in European Application No. 05737636.0 filed Apr. 20, 2005.|
|53||Office Action mailed Jul. 7, 2009, in U.S. Appl. No. 11/110,968, filed Apr. 20, 2005.|
|54||Office Action mailed Jun. 2, 2009, issued in U.S. Appl. No. 11/110,653, filed Apr. 20, 2005.|
|55||Office Action mailed May 22, 2009 in Chinese Patent Application 200580011803.6 filed Apr. 20, 2005.|
|56||Office Action mailed May 30, 2008 in Chinese Patent Application 200580011803.6 filed Apr. 20, 2005.|
|57||Office Action Response filed Dec. 1, 2009 in U.S. Appl. No. 11/110,653, filed Apr. 20, 2005.|
|58||Office Action Response filed Jan. 7, 2010 in U.S. Appl. No. 11/110,968, filed Apr. 20, 2005.|
|59||Office Action Response filed on Jan. 11, 2008 U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|60||Olsen, "Theoretical approach to intraocular lens calculation using Gaussian optics," J Cataract Refract Surg 13:141-145 (Mar. 1987).|
|61||Olsen, "Theoretical, computer-assisted prediction versus SRK prediction of postoperative refraction after intraocular lens implantation," J Cataract Refract Surg 13:141-145 (Mar. 1987).|
|62||Orr et al., "Manifest Refraction Versus Autorefraction for Patients with Subfoveal Choroidal Neovascularization," Investigative Ophthalmology & Visual Science 42(2):447-451 (Feb. 2001).|
|63||Oyo-Szerenyi et al., "Autorefraction/Autokeratometry and Subjective Refraction in Untreated and Photorefractive Keratectomy-Treated Eyes," Arch Ophthalmol, vol. 115 (Feb. 1997).|
|64||Oyo-Szerenyi et al., "Autorefraction/Autokeratometry and Subjective Refraction in Untreated and Photorefractive Keratectomy—Treated Eyes," Arch Ophthalmol, vol. 115 (Feb. 1997).|
|65||Quiroga, et al., "Fourier transform method for automatic processing of moire deflectograms," Jun. 1999, Society of Photo-Optical Instrumentation Engineers, pp. 974-982.|
|66||Raj et al., "Clinical evaluation of automated refraction in anterior chamber pseudophakia," British Journal of Ophthalmology 75:42-44 (1991).|
|67||Raj et al., "Objective autorefraction in posterior chamber pseudophakia," British Journal of Ophthalmology 74:731-733 (1990).|
|68||RCE and Amendment filed Jul. 30, 2010 in U.S. Appl. No. 11/110,653, filed Apr. 20, 2005.|
|69||Request for Continued Examination and Amendment filed on May 11, 2009 in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|70||Response to Restriction Requirement filed on May 3, 2007, in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|71||Restriction Requirement issued on Apr. 10, 2007 in U.S. Appl. No. 10/820,635, filed Apr. 8, 2004.|
|72||Sanders et al., "Comparison of the SRK(TM) formula and other second generation formulas," J Cataract Refract Surg 14:136-141 (Mar. 1988).|
|73||Sanders et al., "Comparison of the SRK/T formula and other theoretical and regression formulas," J Cataract Refract Surg 16:341-346 (May 1990).|
|74||Sanders et al., "Comparison of the SRK™ formula and other second generation formulas," J Cataract Refract Surg 14:136-141 (Mar. 1988).|
|75||Senjo, et al., "Prediction of Postoperative Refraction Using Intraoperative Retinoscopy," Journal of Japanese Ophthalmological Society, 1999, vol. 103, No. 7, pp. 551-555, Abstract.|
|76||Siganos et al., "Autorefractometry after laser in situ keratomileusis," J Cataract Refract Surg 29:133-137 (Jan. 2003).|
|77||Straub et al., "Design of a compact Shack-Hartmann aberrometr for real-time measurement of aberrations in human eyes," 2000 Optical Society of America, pp. 110-113.|
|78||Supplemental Amendment filed Apr. 1, 2010 in U.S. Appl. No. 11/110,968, filed Apr. 20, 2005.|
|79||Supplementary European Search Report for Application No. 05737636.0, Dated Mar. 19, 2009.|
|80||Suto et al., "Adjusting intraocular lens power for sulcus fixation," J Cataract Refract Surg 29:1913-1917 (Oct. 2003).|
|81||Thall et al., Linear Regression Software for Intraocular Lens Implant Power Calculation, American Journal of Ophthalmology 101:597-599 (May 1986).|
|82||Thompson et al., "A New Posterior Chamber Intraocular Lens Formula for Axial Myopes," Ophthalmology 91(5):484-488 (May 1984).|
|83||Tromans et al., "Accuracy of intraocular lens power calculation in paediatric cataract surgery," Br J Ophthalmol 85:939-941 (2001).|
|84||Tseng, et al., "Calculating the optimal rotation of a misaligned toric intraocular lens," J Catactact Refract Surg, Laboratory Science, Oct. 2008, vol. 34, pp. 1767-1772.|
|85||Wiechens, et al., "Bilateral Cataract after Phakic Posterior Chamber Top Hat-style Silicone Intraocular Lens," Journal of Refractive Surgery, Jul./Aug. 1997, vol. 13, No. 4, Cover and Table of Contents in 2 pages, pp. 392-397.|
|86||Zaldivar et al., "Intraocular lens power calculations in patients with extreme myopia," J Cataract Refract Surg 26:668-674 (May 2000).|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|WO2013165689A1||Apr 17, 2013||Nov 7, 2013||Clarity Medical Systems, Inc.||Ophthalmic wavefront sensor operating in parallel sampling and lock-in detection mode|
|Jul 2, 2010||AS||Assignment|
Effective date: 20100510
Owner name: WAVETEC VISION SYSTEMS, INC.,CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:IANCHULEV, TSONTCHO;REEL/FRAME:24630/201
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:IANCHULEV, TSONTCHO;REEL/FRAME:024630/0201
Owner name: WAVETEC VISION SYSTEMS, INC., CALIFORNIA